HoUinger Corp. 
pH8.5 



D 628 
.L8 
Copy 1 



On the Battle-Scarred Fields 
of France. 



A Physician's Impressions of the Medical Services 
of Both the French and German Armies. 



By Adolfo Luria, Ph.D., M.D., 

920 Independence Boulevard, 

Chicago, Ii,i,. 



Reprinted from Medical Council 

420 Walnut Street, Philadelphia, Pa. 

Sept., Oct., Nov., 1918 



Gift 

Author 



^ 



V 



On the Battle-Scarred Fields of France. 



A Physician's Impressions of the Medical Services 
of Both the French and German Armies. 



THESE LINES are just impressions; they are 
not intended to be raised to the dignity of 
a complete account of the status of the medico- 
surgical and sanitary organization of the belliger- 
ents. Eather are they the findings of a student, 
who was willing to learn, by keeping his mouth 
shut and his eyes and ears open to all that was to 
be seen and heard, near and around him. in those 
memorable days of the latter part of 1914, when it 
was his privilege to be in the war zone. 

It is by the mistakes of yesterday that we learn 
how to do better today and, still better on the 
morrow. 

With this fact well grounded in my mind, and 
feeling as every red-blooded American has felt long 
since, that sooner or later our own fair land would 
be drawn into the vortex of the maelstrom that 
engulfs Europe, by a force over which we had no 
control; this fact, I say, decided me then and there 
to see as much as I was permitted to see, and to 
assimilate as much as I could assimilate for the 
purpose, that, should ever the time arrive, I might 
be able to narrate my experiences thus garnered 
for the use and benefit of the Service of our own 
Army. 

When the fate of two nations is hanging in the 
balance on the point of the sword, one can readily 
conceive why the movements of a stranger must, 
of necessity, be limited. The best of credentials 
under those conditions count for naught. You 
simply have to look pleasant, smile and be grateful 
for ever so tiny a glimpse you are permitted^f what 
is going on behind the curtain; hence, what I shall 
relate is only fragmentary of what I have seen at 
the time and places of my visits; but I shall relate 
facts, pure and simple, such as I possess them. 
For this very same reason I shall refrain from 
commenting on the French or the Grerman serv- 
ices. Suffice it to say, that they are different — 
must be different — ^by the very essence and nature 
of things ; and, what is more, by reason of the dif- 
ferent conditions under which these two services 
were and are still operating, their status is not a 
fixed one but is one that is subject to change from 
day to day, from hour to hour, according to the 
pressure and exigencies of the fortunes of war! 
under which the contending forces operate. Hence,!, 
conditions were different at different posts of the 



same units, and often similar or nearly alike in 
the posts of contending armies. War is not a re- 
specter of fixed rules and well-balanced, sedate 
orders. It strikes with fulminating rapidity at 
everything, here, there, everywhere. 

C'est la guerre! 

Et a la guerre, comme a la guerre, 

Voila tout! 

The Sadden Tide of Invasion 

With the force of a steam-roller Germany first 
invaded little Belgiinn, then overran, in those criti- 
cal days of August, 1914, northern France. Hun- 
dreds and hundreds of kilometers she occupied by 
force of arms — away from her own borders. 

She was then, as she is now, with both heels in 
enemy's land, knocking at the capital's door and 
stretching forth her mailed fist to grab some more 
vital points, some more important cities. Tet, 
with a stout heart and an indomitable will nat to 
be conquered. France fought and fights yet. valiant- 
ly, courageously, heroically, so as to compel the 
admiration of even her hereditary foe. In her medi- 
co-military service, France had then, as she has 
now, a decided advantage. She could then, as she 
can now, rely on the good-will of her home towns, 
her cities, big and small, wherein to mobilize and 
distribute to best advantage her mobile military 
medical and sanitary service. But not so with 
Germany; she, the invader, was and is in this re- 
spect at a disadvantage. She was compelled to 
create, to equip and to provide for, new hospital 
units in enemy territory, a territory naturally hos- 
tile to her forces, a territory often destroyed by 
enemy and friend alike, according to the tragic 
exigencies of the war. And what was the result? 

German Method 

I With an uncanny, methodical effort she over- 
came the obstacles and solved thus her sanitary 
problems; and, while France could call and did 
call into her service her city halls, her public 
buildings, her hotels, and transformed these into 
establishments for the care of her wounded and ill, 
listributing them in proximity to the firing lines, 
ipportioning her units in a methodical manner, 
^hanks to the innate patriotism of the French na- 
tion, such units sprang into existence like mush- 
rooms, over night, while private homes threw open 



their portals to welcome the defenders of France, 
each and every citizen vying with each other to 
outdo themselves in deeds of patriotism, nothing 
of the kind happened to Germany. She was com- 
pelled to rely wholly and solely on her own mili- 
tary-sanitary organization and the resources of her 
own Eed Cross body, hence she was by force of 
necessity compelled to create new and great hospi- 
tal units, so that there should emerge, as it did 
emerge, a nucleus, with a kind of centralization 
power, for the better care and surveillance of her 
stricken and wounded. 

The question now arises : how did she do it ? 
Well, first of all, she brought from Germany into 
the invaded and occupied territory large barracks. 
Those barracks constituted the nuclei spoken of 
above. These she managed to dispose near to and 
around industrial centers. There she seized the 
immense factories that dotted these regions, con- 
verted then into hospitals, and when such a fac- 
tory was entirely or partially wrecked, she took it 
upon herself to rebuild or to repair the damage. 
The wounded that could stand a protracted trans- 
port were transferred to her own soil. There, too, 
as in France, her people opened their doors to the 
wounded and maimed to give them the best of 
care. Recuperating places sprang into existence, 
maintained either by private means or by the 
Government. Thus the President of the Reich- 
stag turned over his palace for the use and com- 
fort of the womided. But the ideal places for such 
purposes, as I found them extant in Nizza, Mar- 
seilles, Lyons, Dijon and Paris, I have foimd no- 
where within the German lines, and I have visited 
a good many of them — before Rheims, Verdun, St. 
Quentin as well as at Valenciennes and Brussels. 

The Sanitary Services 

With reference to the structural organization of 
the sanitary services of the two parties, all I have 
to say is, that they are made up almost on iden- 
tical lines. Thus, the French Poste de secours 
finds its equivalent in the German Truppen Ver- 
iandplatz; the French Hospital de Campagne is 
the German Feld-Lazzarett; the Hospital d'Eiapes 
is the German Etappen Lazzarett, while the Hos- 
pital de reserve finds its counterpart in the Re- 
serve und Vereins-Lazzarett. 

In the armies of both nations the soldier is fur- 
nished with a small sterilized emergency package, 
so disposed that the lightly wounded may apply it 
to himself without incurring any danger. The Ger- 
man package is smaller and more compact than the 
French one; it is easier to handle, and it is en- 
closed in a little pocketbook hung obliquely over 
the left side of the jacket, from where it can be 
reached, extracted and opened by either hand, 
while the French carry in addition to these emer- 
gency packets some vials filled with the tincture of' 



iodine, with a view that the wounded himself may, 
even before medical help can reach him, disinfect 
his wounds, provided he is wounded only very 
lightly. Heiney and Fritzi must forego this vial, 
because it has been found that Heiney is rather 
given over to the idea of "the more, the better," 
and his indiscriminate and lavish use of the tinc- 
ture had caused him some startling and unpleasant 
after-efi^ects. Hence, he must await his regimental 
doctor's service, either in the trenches themselves 
or at the Truppen-V erhandplatz, and where a med- 
ical officer is not available, some medical nurse is 
surely" there to attend to his first-aid needs. The 
wounded are gathered together into the Ti-uppen- 
Verhandplatz; those able to march go there on foot, 
or they are brought in by litter-bearers. The wound- 
ed may or may not have received first medical 
aid by that time; but at the Truppen-Verhandplatz 
more appropriate attention is given to the nature 
of the wound and the adequate and appropriate 
handling of the case proper. Here the most urgent 
cases come first; thus, those that have been gassed 
or nearly asphyxiated, are quickly resuscitated; 
collapse, severe hemorrhages are immediately over- 
come by proper measures; fractures are coapted, 
dislocations reduced, and the injured limb immo- 
bilized. Limbs that cannot be saved are here, if 
possible, amputated, and every wounded man is 
guarded against tetanus by the injection of anti- 
tetanic serum. 

When the V erhandplatz is too busy, those that 
can march go then to the nearest Haupt-V erhand- 
platz., or they are taken there by litter-bearers; 
or they may even go to the nearest Feld-Lazzarett. 
For those who cannot be removed or cannot come 
out from the trenches, because such an attempt 
would be too perilous an undertaking by reason of 
the enemy's fire — for those then, wherever it is 
possible, the regimental officers must step in and 
take care of them ; but, more often, owing to the 
peril that attends their bringing in, these poor 
wounded must remain just where they are until 
late at night, or perhaps they must await a more 
propitious moment to be taken up and brought 
in. 

Terrible Bailie Conditiona 

I have witnessed cases, and I have it from the 
lips of the wounded themselves, that often many 
of them had lain in the path of the raging battle 
for four or even five agonizing days without any 
aid whatsoever. Late at night I have often seen 
the Sanitary Corps come out and go directly to- 
ward the trenches and the battle lines; a long line 
they form of sanitary vehicles; these were drawn 
by horses because of the impassability of the roads 
and the impracticability for the use of automo- 
biles, for, besides the light projected by the auto- 
mobile reflectors, the noise produced by the motor 



readily attracts the attention of the enemy and 
constitutes the main drawback to their use. 
Hence, autos are used only when and where the 
roads are in good condition between the Eaupt- 
verhandplatz and the Feldlazzarett, or where their 
line of communication is, even in the daytime, 
safe from the enemy's fire. 

Location of Units 

The Sanitary Section takes its place near to but 
yet at a safe distance from and behind the firing 
line. It is somewhat farther in the rear than the 
Tinippen-Verhandplatz, protected as much as it is 
possible to protect it from the artillery of the 
enemy; this is, with respect to the care of the 
wounded, the most important post of the entire 
sanitary service, simply because these first treat- 
ments are often the treatments that are the decid- 
ing factors of the fate of the wounded. Especially 
is this true of present-day warfare methods. Erom 
there the wounded are rapidly removed to a sur- 
gical post, where, with adequate means, instru- 
ments, and under the special care of trained mas- 
ters in combating diseases, many a grave surgical 
complication that otherwise would have manifested 
itself, is thus forestalled. 

One of these German sanitary sections I visited 
was located near a wood, half buried in the ground 
to facilitate its heating up. The roof was, as it 
is, as a rule, in such oases, covered with green 
branches of pine, birch or other trees. These 
branches are their camouflage, serving for the pur- 
pose of hiding their existence from the ever-vigi- 
lant eyes of the enemy aeroplanes. All the barracks 
that belong to such a section can be put up within 
two hours and taken down in less than one hour's 
time. They have operating rooms for septic as 
well as operating rooms for aseptic cases, and also 
disinfecting rooms, etc. The service of each unit 
is constituted by the personnel of nine officers. 
Three of these are surgeons, four medics, one is 
an oculist, one a chaplain, and a number of nurses, 
and it can accommodate two hundred wounded. 

The Typical German Soldier 

The German soldier combines his industry with 
an instinct of organization; therefore, the moment 
he enters a section he sets himself to the self-im- 
posed task of bettering his condition by making 
his quarters more comfortable by adding to it, 
despite the fact that he is well aware that he might 
have to relinquish his hold on his quarters any 
moment to the Franzman. Thus, I saw that, in 
addition to the regulation barracks in a little wood, 
hardly 6 km. from the firing line, ever so many 
more additions made with the wood that the forest 
offers. Some served for additional sick wards, one 
was used as a chapel, others were for the officers' 
club rooms, while still others served as extensions 
to the kitchens. There were also spacious stables, 



large enough to accommodate from SO to 100 
horses, and garages for the housing of the autos 
used by that sanitary unit. There was enough 
space there to accommodate with comfort 200 
wounded, besides its staff members and personnel 
of the infirmary service. There were also kennels 
for the housing of wolf-dogs. These dogs were 
trained to explore the battlefield and even to ven- 
ture into "No Man's Land," to search, find and 
assist in the bringing in of many a wounded sol- 
dier; and let me record it here, to their everlasting 
credit, these intelligent animals performed deeds 
that were simply stupendous. 

Hans "Kept the Pig in the Corner" 

In the same unit there was also space staked 
off for the fattening of swine; they were fed on 
all the table refuse, and they, in turn, furnished 
Heiny in due time with some dainty morsels of 
ham and other porcine delicacies. 

The rooms were equipped with instruments and 
sterilization apparatus, such as one would expect 
to encounter in a first-class, modem hospital, 
ready to cope with any major operation. 

Makeshift Bedding 

Beside the reglementary ambulance bedstead, 
there were others to be seen of quite a different 
pattern. Here, too, the practical proclivities of 
the German mind came to the service for a good 
purpose. The reason for it was as follows : their 
march, in its initiatory phase, was executed with 
great rapidity; it was because of the able Fabian 
strategy of Joffre, beyond their own expectations, 
hence, in such an onslaught, and they being the 
aggressors, it was natural that their casualties 
should, as they did, pile up to a degree they never 
expected it to attain. Therefore, not being pre- 
pared for such an emergency, they were short of 
beds; but the commissariate carried foodstuffs well 
packed in wooden cases. These cases they utilized, 
and thus with this rough material they built 8,000 
beds, roughly made to be sure, but quite comfort- 
able and provided with straw mattresses where 
hair mattresses were not to be had. 

Operating at Night 

Inasmuch as the wounded were all brought to 
the Haupt-Y erhandplatz or the Feld-Lazzarett in 
the dead of the night, it follows that the opera- 
tions were performed, for the most part, at night. 
Hardly had the ambulances arrived at their desti- 
nation when the work to operate was started. The 
operating rooms wei'e lighted either by gas or by 
alcohol lamps. Everything worked clip-clap in the 
first and best of shape, under the most rigorous ob- 
servance of aseptic methods, each of the operators 
a specialist in his line of work, with assistants 
trained to interpret a motion, to anticipate a move, 
and to know beforehand the desire of their mas- 
ters. Under such conditions it is not to be won- 



dered at that even the most difficult operations 
were fruitful of splendid results. Especially is this 
true when we remember how much depeiids on a 
correct operative measure, how much it influences 
the outcome of a major operation performed either 
on the head or in the abdominal cavity. In the 
latter case we know that the prognosis is by far 
a better one if we are able to operate within twelve 
hours after the woimd has been sustained; this, 
plus adequate preparations in an adapted locality, 
and provided with the best of surgical means 
handled by competent operators, who have all the 
time at their disposition to do first-class work, 
nothing more ideal could be desired; and all these 
conditions were, in 1914, prevalent in most of the 
German sanitary campaign units. 

Deferred Surgery 

But to every obverse of a medal there is the re- 
verse side of it, and so it was with their cases, just 
as there is a shadow to every light. Not all of the 
units presented such a roseate hue as described 
above. There were cases, naturally, which for ob- 
vious reasons could not be operated upon within 
the ideal time limit of twelve hoiirs; and there 
were cases for which neither the surromidings, 
nor the means, nor the surgeons best fitted to cope 
with all the intricacies of a fine technic that the 
gravity of the case required were at hand; then, of 
course, they had to rely on the vis medicatrix na- 
turae of the individual and hope for the best. 

Fearful Sigliis 

The spectacle of thousands and thousands of bits 
of humanity, shot to pieces in all sorts of shapes 
and forms, is not a cheery one; and going from 
bed to bed, visiting and ministering to them, eas- 
ing their pain and cooling their aching brows, re- 
quires a stout heart and a particular heroic nature 
of its own. 

Glory to the doctors of any race who, with a 
self-abnegation second to none devote the best that 
there is in them, so that pain may be assuaged and 
a life may be saved! They should do this un- 
selfishly, indiscriminatingly, be the issue the life of 
a friend or that of a foe. Before the majesty of 
suffering all enmity should cease, and the charity 
and the divine brotherhood of men come into its 
own and reign supreme. 

Oft I have asked myself the question : "What 
is the hardest thing to contend with among the 
Golgothas of sorrow and pain?" and I frankly ad- 
mit that I cannot say with precision what it is. 
I saw some terrible cases of disfigurement and I 
met some horrible poison cases, but the most piti- 
ful cases, to my mind, were the shell-shock cases. 

In one of the sections I had occasion to inspect 
a few laparotomy cases which had been operated 
upon early, and consequently all were now on the 
high road to recovery. In all these case? the 



wounds were caused by small firearms. What sur- 
prised me somewhat was the fact that neither 
within the German nor within the French line 
miits did I come across a case wherein the Murphy 
button had been used. The fear that I expressed 
in another paper, some twenty years ago, that the 
indiscriminate use of it in supra-public sections is 
fraught with dangers, that often the sigmoid flex- 
ure would be found so narrow as to obstruct its 
passage through it, was vindicated at the front. 
French and German surgeons alike told me that 
in their hands it did not act so brilliantly as we 
saw it work in the hands of our late lamented John 
B. Murphy. 

TAe First Dressing Station 

In some of the first dressing stations, both in 
France and Germany, I saw some dangerous scalp 
wounds that had received inunediate and adequate 
attention. All causative factors of compression 
had been removed and the wounds aseptically 
treated, with the best of results. However, not all 
serious eases could "be treated there, because de- 
spite the fact that there was a more than ample 
ambulance service, with a great number of autos 
at their disposition to take care of the wounded, 
by fetching them from the Paste de secours or the 
Truppen-V erhandplatz to the Hospital de Cha/m- 
pagne or the Feld-Lazzarett, yet the evacuation sta- 
tions were nearly always full to an overflowing 
and hence, not all that were there could be at- 
tended in an adequate maimer. Many of the cases 
therefore I witnessed myself were taken from the 
front directly, either to the Hospital de Campagne 
or to the Hospital d'Etape. All they were given 
was some kind of a first dressing or medication; 
and then they were sent on their way where better 
care and attention could be given them. Each 
wounded carried, tacked on his jacket, a little 
note that gave in a general way a history of the 
case, the nature of the wound or malady, and what 
medication or treatment were already administered. 
When, however, after a serious engagement, or 
after a big battle had been fought, the number of 
wounded brought in reached into staggering 
ciphers, then, and only then, were the activities 
of the surgeons wholly, and solely limited to the 
most urgent eases, either of the seriously wounded 
or the gravely ill ones; while the others were ex- 
pedited with the greatest dispatch toward the ter- 
ritorial hospitals, where they were evenly dis- 
tributed and properly taken care of; but, under no 
circumstances was one put on his journey if there 
was the slightest doubt in the mind of the attend- 
ing physician or surgeon that such a journey might 
aggravate the case or imperil the life of a patient. 
Immense Casaalties 

If we pause for a moment and reflect that after 
the battle at the Marne was fought and won, the 



casualty list of the French showed the stupendous 
figure of 1 12,000 wounded alone, and that during 
the twelve days that followed the beginning of the 
hostilities at Ypres, 100,000 wounded German sol- 
diers were sent forth from the distributing sta- 
tion of Brussels toward Germany, then one will 
easily comprehend the why, as well as the where, 
of all surgical preparations, no matter on what a 
vast scale of preparedness undertaken, had, of ne- 
cessity, to remain inadequate. ISTot even the well- 
organized German sanitary service could cope with 
it, despite the fact that they were evenly distrib- 
uted and magnificently equipped all along the terri- 
tory of the war zone. From Attigny to Vouziers, 
to Rethel, to St. Quentin and from Caudrey to 
Valenciennes and Brussels, their sanitary units 
were marvels of efficiency and order. Wherever 
and whenever it was feasible railroad branch lines 
were established that ran into and connected with 
the big trunk or main lines, wholely and solely 
devoted to the service of the wounded, who, over 
these lines were sent back to Germany to be treated 
there at the various hospitals adapted for their 
needs. 

Rethel, at the time of my visit, was only 10 Ian. 
distant from the firing line. The place bore all 
the evidences of the terrible havoc war had played 
there. Bombarded first by the Germans, precious 
little left whole of it, it was again bombarded by 
the French, who finished by destroying the little 
that had escaped the German destruction. San 
Francisco, after the terrible earthquake, I am sure 
must have looked like a well-kept garden in com- 
parison with the sight Rethel offered, and yet in 
this place of desolation the Germans dug them- 
selves in like moles, and I well recollect now of 
what once was a fine factory, but then was merely 
a fragment of a ruin, which the Germans suc- 
ceeded in rebuilding and converting into a mili- 
tary hospital with a capacity of 1,650 beds; besides, 
this factory-hospital was fully equipped with the 
best and latest radiographic machinei-y, with well- 
ventilated, spacious operating rooms, disinfecting 
and sterilization compartments, such as one would 
expect to find in a first-class hospital in New 
York or Chicago. 

Isolation Hospitals 

In and around the nearby villages, with the 
hospital as a central unit, thirty-five or more bar- 
racks were built aroimd, which, in their turn had 
a capacity of 2,700 beds. These barracks were, 
for the most part, used for observation and isola- 
tion of infectious diseases, notably typhus fever 
and small-po.x. The sections were divided into 
three groups; in the first group the very severe 
cases were kept under constant attendance, in the 
second group the convalescent found lodgment, 
while in the third group the quarantined ones were 
kept under constant observation. All sick mem- 



bers of that unit had to pass through all these 
three groups, and they were not discharged from 
the third until their feces, which were examined 
weekly, had riot shown for three consecutive exam-, 
inations that, as far as specific organisms are 
concerned, the findings were absolutely negative. 
This proved the cases to be immune, and only after 
such negative tests were they discharged as cured. 

These barracks were for the most part erected 
in some forlorn, uninviting, barren place, where, 
as a rule, the mire was kneedeep, yet the conva- 
lescent Germans succeeded in transforming these 
desolate places into splendid garden spots. The 
military authorities encouraged it, and even of- 
fered premiums and prizes for the best kept or 
most beautifully laid out garden spot; and all this 
was going on while the big cannons roared and the 
shrapnels whizzed and shrieked their song of 
death all around. 

In these barracks as well as in other units I 
found the most modern hygenic principles applied 
and translated into practice. The feces were all 
collected and disinfected with chloride of lime, 
everything was cleanly washed and sterilized, from 
the covering of beddings, bed sheets, etc., to the 
drinking water, wine, eating stuff, utensils and so 
on. Everything had to pass through the hands of 
capable inspectors. 

To each sanitary unit there was attached a bio- 
logical cabinet. The hospital sections were all 
lighted by electricity. Where the electrical plant 
was out of order, or was wanting, there was at 
some little distance a place where the electrical ^ 
energy was generated. Even in places which, prior 
to the war, never Ichew of the existence of such a 
thing as electricity, under the exigencies and stress 
of the war, electric service was there. Even the 
trenches were so supplied, and there the force 
sei-ved a double purpose, to wit, for lighting as 
well as for heating purposes. 

Everywhere I found established sections for full 
baths, sitz-baths and douches. In a little village 
near the firing line, where the roof had to be rt- 
constructed, I found such a balenaria. At the time 
of my visit there some Prussian and Saxon sol- 
diers, who just had come out from the trenches, 
were taking the baths. First, they changed clothes ; 
then were examined and assigned to a bathing sec- 
tion. One section was set apart as the Entlaus- 
ungs-Stelle, to rid them of vermin and scabies. 
This section was fully and adequately equipped, in 
addition, with special and sterilization apparatus. 

Radiography 

Attached to every surgical section there was a 
radiographic cabinet. Outside of these fixed cabi- 
nets there were maintained radiographic cnbinets 
on either auto trucks or on trucks draAvn by hiirses, 
ready to lie used here, there, everywliere, wlieve tlie 



urgency of the case required their presence. I saw 
many of these apparatuses in the field hospitals as 
well as in the territorial ones, and I saw some am- 
•bulatory ones at the great military units. Sani- 
tary authorities prefer the fixed ones to those ol 
the ambulatory type, because the loading and un- 
loading always entailed a loss of time: besides the 
transportation in itself from one i^laee to another 
involved the danger of getting them out of order. 

It seemed to me that Germany was compelled to 
erect, create and establish medico-surgical units, 
despite all difficulties tliat were in her way and in 
the very nearest vicinity of the firing lines, in a 
territory over which constantly the storm of raging 
battles centered; and all these units wei-e amply 
provided with adequate means to be in shape to 
cope with all sorts of conditions and emergencies 
that arose out of these battles. The territorial 
hospitals were reserved to look after the care of 
the convalescent, or to handle the after-treatment 
of all traumatic cases. Besides these there were 
instituted reclaiming stations to make the maimed 
ones, as far as science permitted, capable to reas- 
simie their physical functions by means of artificial 
apparatus, etc. 

However, after a big sanguinary battle, when the 
number of wounded assumed staggering propor- 
tions, then, and only then, was it that those who 
did not require immediately urgent treatment, were 
directed at once toward Germany, and in this ef- 
fort they were helped by the wonderful net system 
of railroads they had devised especially for that 
purpose. 

Among the French centers it was my good for- 
ture to visit, Creil and Amiens stand out in bold 
relief. 

Amiens is one of the most important hospital 
centers of the French army. At the time of my 
visit, it was some 20 odd kilometers distant from 
the firing lines, with which the city was intimately 
connected by a very efficient automobile service that 
radiated in all directions. I visited there various 
hospitals. Some units were located in public build- 
ings, others were in the civic hospitals of the city. 
One of the .units there belonged to the 14th Divi- 
sion of the Ninth Army Corps, ably supervised by 
Prof. Ambroise Monprofit of Angers. 

The wounded were brought into Amiens either by 
automobiles, or by vehicles drawn by horses. They 
arrived either directly from the trenches or from 
some Paste de Secours. They all were landed under 
the vast roofing of the railway station. Each and 
every one had his identification schedule pinned on 
him. This schedule gave in a general way a sum- 
mary of the nature of the wound or illness of the 
patient. There at the station they were re-examined, 
and each and every one assigned to one of three 
distinct classes. 



To the first belonged all those who needed but 
little treatment, at best only a few days of rest to 
recuperate their strength, and these after a short 
period were promptly returned to the front. To the 
second were assigiied all those ill and wounded who 
needed a protracted course of treatment. These 
were sent home to their territorial and departmental 
hospitals. To the third and last class were assigned 
all seriously ill and wounded who needed urgent at- 
tention. 

Often these cases were treated right at the station, 
but wherever and whenever practicable it was pre- 
ferred to send them to the hospital units of Amiens 
itself. As soon, however, as they were in condition 
to travel, they were sent from there to a more dis- 
tant hospital. 

Evacaation Hospitals. 

At the evacuation hospital of Amiens, located at 
the railway stations, I saw 300 beds constantly kept 
in readiness to receive patients. I found there oper- 
ating rooms, as well as a perfectly maintained 
emergency service, ready to minister and to take 
care of the most urgent cases. At one time I wit- 
nessed the arrival of 30 autos, full of wounded. I 
saw each one re-examined and assigned to his proper 
class. I saw them placed on a sanitary train of 
third-class carriages, taking these heroes of France 
back to their home departnients to recuperate. 

All went on with an order and precision worthy 
of the highest encomiums and traditions of the 
French Army. I heard no voice raised in protest, 
nor did I hear any one complaining; they suffered 
in silence and with dignity — these noble sons of a 
truly great nation. 

Hospital Trains. 

The trains, I was told, could each acconimodate 
600 wounded. They differed from the German troop 
trains in that no medical officer went along with 
them. Only the nurses went with them, and they 
saw to it that nothing was wanting. However, in 
cases of need, a medical officer was always in at- 
tendance or could be easily found at any of the 
principal stations these wounded and ill had to pass 
through on their long journey. Those cases who by 
reason of the voyage became aggravated were 
promptly removed from the train and taken to the 
hospital unit of that place. 

By direction of the Central Command of Paris 
that has supervision of such cases, the wounded and 
ill were sent from the evacuation hospitals to the 
various departmental and national hospitals, and 
distributed among these ; according to the beds, each 
unit had at its disposition. The sanitary train of- 
ficials were beforehand apprized by wire of the 
precise time of the arrivals of such trains. These 
wires went also to the officers of the departmental 
headquarters, who were charged to see to it that the 
correct division and distribution of the wounded 
should be made. 



Being informed daily of the train movements, 
tliese officials were, therefore, beforehand in a posi- 
tion to take the necessary and appropriate steps to 
distribute the new arrivals between the territorial 
hospitals that were best adapted for the handling 
of the cases, according to the nature of the disease 
or the degree or severity of the wound of the in- 
dividual. 

Central Territoritil Hospitals. 

In France, by virtue of the proximity of the fir- 
ing lines, the main central territorial hospital units 
are located at Paris, Lyons and Dijon. But, where 
pure air and ideal climatic conditions are sought as 
adjuvants to treatment, then Nimes, Menton, Cannes 
and all the beautiful Riviera towns easily win the 
palm ; hence southward, toward the land of sunshine, 
great numbers of the wounded are directed. By reason 
of what is stated above, the French service had not, 
and did not, need nearly as many sanitary units as 
the German service was required to maintain, nor 
were the Freiich units at the front so lavishly 
equipped as the Germans simply because the French 
had, and still have, ample facilities to fall back on 
their home units. I have seen patients with scalp 
wounds exhibiting all the symptoms of compression 
coming directly from the front, arriving at terri- 
torial hospitals, having traveled probably for a few 
days, only to undergo treatments there. I saw 
compound and comminuted fracture cases, under 
the same conditions, who had received only a pri- 
mary dressing. 

Changing Methods as War Changes. 

Such a sanitary service was, up to the present 
war and for all intents and purposes, an adequate 
one, simply because the lesions produced by the fire- 
arms of former wars always pursued a benign and 
favorable course ; hence it was good surgical practice 
to send the wounded, after they had received either 
an emergency or primary dressing, to some better 
equipped hospital. But this war is an entirely dif- 
ferent proposition; and this fact the French were 
the first to recognize. Hence their front service 
today is by a far cry a better one than the one 1 
saw nearly four years ago. Today their front serv- 
ice is second to none, and those who have charge 
of the service are the master minds of the medico- 
surgical world of France — and that means some- 
thing. 

Now what are the causes that producea such a 
change? Well, they are manifold indeed! Fore- 
most, however, among them all is the fact that the 
small firearms had to give way to grenades ,and 
shrapnel and cannon of gross calibre. Translated 
into traumatic results, this means that wounds pro- 
duced by such weapons tell a more sweeping and 
disastrous tale. 

And while as late as the Italo-Turkish-Tripolitan 
war, or to come still nearer home the last two Bal- 



kan wars, the number of wounded hit by balls from 
rifles still amounted to nearly 85-90%, while those 
produced by cannon or other gross caliber arms 
amounted only to 10%, at best to 15%; today the 
reverse marks more nearly the truth. 

Character of Woands, 

I saw more wounds produced by cannon than due 
to rifle shots. True, the reason may lie in the fact 
that the rifle wounds heal quicker, hence there 
was less opportunity for their observation by a mere 
casual visitor than by a regular attendant. As a 
matter of fact, I saw many soldiers who had been 
wounded twice or thrice, and who had returned to 
the trenches after only a few days of illness. In 
this instance I refer to rifle wounds produced b,y 
small caliber projectiles thrown from a great dis- 
tance, whose vital force is quite irrelevant. But 
there is a diff'erent tale to tell in the ease of wounds 
produced by the selfsame arm and projectile thrown 
out at a sho7-t distance, whose disruptive force in 
consequence is an enormous one. Under such latter 
conditions, wounds thus produced assume quite a 
grave aspect indeed, simply because the explosive 
character produces in the organs hit extensive, de- 
structive lesions, often tearing everything to pieces 
— similar to the destruction produced by a bomb. 
Especially is this true of organs tEat contain liquids, 
such as the heart, containing blood; or semi-solids, 
such as the cranium, containing the cerebral mass; 
while in the liver or muscular system it produces 
lacerations having but a small entrance, but in 
which the wound becomes larger and larger and 
more conical in shape as it nears the exit of the 
projectile. 

Another aggravating factor that has often been 
observed is the fact that, not infrequently, the pro- 
jectile in its trajectory, and before reaching and 
hitting its victim, encounters in its course some 
hard impediment that flattens it — and in this con- 
dition it ricochetes or rebounds, hitting the soldier 
in this rebound. Wounds thus produced are of ne-. 
cessity irregular in shape and by far more lacerative 
and destructive in character than are the wounds 
due to other projectles. Inasmuch, as nowadays 
battles are often fought out with the opposing 
trenches at a short distance from each other, such 
mishaps are of quite common occurrence. When 
these experiences, at the beginning of x,ne war, were 
quite new and their causative factoi still was un- 
known, it led to the most acrimonious accusations, 
hurled by the contending armies at each other, of 
being guilty of uncivilized warfare by the use of 
dum-dum bullets. This much for wounds produced 
by rifles. 

Shell WoanJs. 

Now, how about the wounds inflicted by artillery ? 
Here, too, even in a greater degree, present warfare 
has produced new and terrible types of lesions, un- 



known before in seriousness and destructiveness. 
They are particularly due, first of all, to the more 
extensive use of cannon of gross calibre, as well as 
to the great state of art and perfection inherent 
in these monster weapons; hence the requisite 
greater efficiency in markmanship has evolved a de- 
structive potentiality never heard nor dreamed of 
before, so that, nearly every shot fired carries de- 
struction with the maximum of telling force. Not 
a little credit for this precision is due to the eyes of 
the army — the bird-man in his aeroplane — who with 
the greatest precision maps out and signals the 
enemy's exact position. 

I have noticed but little difference in the effects 
produced in wounds due either to the French gren- 
ade or to the big German projectiles. The French 
grenade, such as are projected by the 75 cm. cannon, 
scatters itself into infinitesimal pieces as soon as it 
bursts, increasing thereby to a manifold degree the 
lesive power of the projectile, yet it inflicts but a 
small wound; the German projectiles burst into 
large fragments, hence, they produce a far larger 
wound. Be this, however, as the case may be, the 
one luminous fact remains, that owing to the greater 
number of cannon used in this conflict, the number 
of shell wounds by far surpasses those produced by 
rifles, and consequently the irregular fragments of 
the grenades or shrapnels are productive of very 
serious lacerations. 

Aside from this fact, there is another element 
inherent to the gross caliber weapons in that the 
wounds so produced are often complicated by the 
danger lurking in infection from pieces of clothing 
Or other septic materials carried by them into the 
wounds, while rifle wounds cause more clearly de- 
fined and less dangerous lesions. Another ominous 
factor of the grenade is its property of bursting on 
the ground and scattering around clouds of earth- 
works, stones and dirt, each of which increases the 
danger of infection. 

Such complications were observed at the begin- 
ning of hostilities and they found their expression 
in the great number of cases that developed tetanus 
or gangrene. However, nowadays, judging from 
the reports, such cases are happily of rare occur- 
rence, thanks to the energetic prophylactic measures 
instituted. True, some inevitable suppurative cases 
are still manifest, but better results are gained day 
by day, and soon these will pass into history as 
things that have been, but are not now, to be 
dreaded. 

Conservative Surgery. 

Out of evil there always arises some good, some 
blessing to mankind; and thiis out of the turmoil 
and strife of this gigantic world war conservative 
surgery came to the fore and into its own. ~No-w no 
longer are amputations made needlessly, but wher- 
ever and whenever possible, a limb is saved. Hence, 



we may well be filled with professional pride at the 
achievements of our profession at the front. 

How were these remarkable results brought about ? 
Simple enough ! They are due to the great in- 
fluence civilian physicians and surgeons have 
brought to bear on the professional medical corps 
of the armies and navies of the contending forces. 
This commingling of the two great branches of the 
profession, the civil and the military, in one homo- 
genous body, was productive of an efficiency never 
heard of before. 

I saw within the German lines, working as su- 
perior military officers, the greatest luminaries of 
the medico-surgical world of Germany; thus I saw 
Peyer at Eethal, Garre at Vouzier, Angerer, Schem- 
mel and Neumann at St. Quentin, while Bier di- 
vided his time between the front and his clinic at 
Berlin. France, on the other hand, can boast of the 
services of Tuffier, one of the greatest living 
clinicians. He has the rank of a general, and I saw 
him supervise the surgical field organization. Be- 
sides him, there were at the front such eminent men 
as Faure, Cuneo, Proust, Schwartz and Lecine, 
While Baudet was at the head of the Italian hos- 
pital for the wounded in Paris, while Quenu, Del- 
bert, Monclaire, Thierry, eminent French surgeons, 
each a master mind, directed somewhere in France 
some important territorial hospital. 

The Civil UospHab. 

In every city in France, as well as in Germany, 
the civil hospitals are given over to the care of the 
wounded; everywhere the military cases take prece- 
dence over the civil ones, and where such a course 
was feasible the latter were mixed up with the 
former. Special care and attention is given to the 
various specialties. Thus, each unit had an oph- 
thalmological, an aural, a genito-urinary, as well as 
orthopedic departments, and last but not least a 
department for brain and nervous diseases. At the 
head of each department an authority of national 
or even international fame, was placed. 

The city of Valenciennes had completed an im- 
posing building that was to serve for school pur- 
poses. It was just to be inaugurated when the Ger- 
mans took possession of tlra city. They converted 
this building into a great neurological institute, 
with Oppenheim, the great neurologist, at the head 
of it, while the far-famed French neurologist, Sicard, 
is at Marseilles at the military hospital of that city. 
Imbert, professor of clinical surgery of the Univer- 
sity of Marseilles, is at the head of the surgical de- 
partment of the same hospital. 

In Germany, to each sanitary unit belonged a 
chemical, a bacteriological, as well as a hygenic cab- 
inet, and each of these were directed by the famous 
professors, by men of known ability in biological 
sciences, by virtue of the positions they occupied 
at the various universities. 



I believe, from observation, that the harmonious 
blending of the military surgeons with the celebri- 
ties from civil life to whom military ranks and 
emoluments were given commensurate to, and in 
keeping with, their high civil status, contributed in. 
no small measure to the splendid results to which the 
sanitary services of the contending armies of France 
and Germany may justly point with pride; because 
from that intimate intercourse and exchange of 
ideas, there sprung into existence a sanitary organi- 
zation that was equal to any emergency, ready to 
cope with any vexing problems that the gravity of 
the moment had engendered — to the everlasting glory 
of the armies to which they beloixged, and, as well, 
a blessing to the thousands and thousands of 
wounded or ill committed to their care. 

The Red Cross. 

Another great factor that contributed to the top 
notch efiSciency of the sanitary service was the help 
and the support that the Eed Cross organizations 
brought to the sanitary services of their respective 
coimtries. 

In France, as well as in Germany, they placed 
their tremendous resources at the disposition of tlie 
sanitary service of "la patrie" or "the fatherland." 
They assumed the task of training and educating 
nurses for the service at the front, and they con- 
trolled and managed hospitals; they organized and 
supervised troop trains for the transport of the 
wounded; they dedicated themselves, in a most un- 
selfish manner, to the sanitary and hygienic defense 
of their armies. 

Right on the heel, at the declaration of war, while 
the military authorities called all men to their 
respective colors, the Eed Cross, as well as all other 
societies that were intimately related or dependent 
thereon, started out to mobilize a true womanly 
army, as a complement to and as an auxiliary for 
the respective fighting armies. And to the glory and 
everlasting fame of the women of both countries, 
they did their duty and responded nobly, conscious 
of the great need their land and nation had for 
them. 

Thus, in Germany, the "Schwestern" or sister- 
hoods, occupy even in peace times a very important 
position. They have charge of the training of all 
nurses; they superintend not only governmental and 
civil hospitals, but they also administered private 
hospitals. They have organized, managed and 
solved the great field sanitary and hygienic prob- 
lems. Wherever there was suffering, the Red Cross 
sisters were there — ready to do their part, to help 
heal the wounded, as well as to mitigate the horrors 
of war. Well trained to a T, efficient in the ex- 
treme, no wonder, then, that such an organization 
was a power for good. 

There is no service, no matter how humble or 
ever so exalted, ever so devolving the highest skill 



and rarest acumen, to which these Red Cross Sis- 
ters everywhere do not lend themselves. Here they 
attend to the official or the private correspondence 
of the wounded ; there they keep the registers or act 
as bookkeepers. This one is the presiding genius 
of the scullery; the other has a knack for keeping 
the instruments in trim shape, while still others 
act as assistants to physicians and surgeons, or as 
radiographers, as chemists, bacteriologists, mechano- 
therapeutists, etc., etc. 

Red Cross Hospitals. 

The French Red Cross embraces three distinct 
and autonomous organizations. 

(a) La Societe Des Secours aux Blesses Mili- 
taires, 

(b) La Union Des Dames Francaises, 

(c) La Union Des Femmes de' France. 

All these three societies have control in peace 
time over many schools for nurses and hospitals, 
among which I'Hospitai, Ecole de la Societe des 
Secours aux Blesses Militawes a Paris is a model in 
itself. 

When war was declared, a great number joined 
their ranks with an enthusiasm so characteristic of 
the French nation. 

Those who in peace time had gone through the 
regular course prescribed for nurses, and who had 
passed a satisfactory examination, were, of course, 
given the first positions available in the Red Cross 
service, while for the later arrivals shorter courses 
were provided to make them available for practical 
service in the shortest possible limit of time. 

Fortunately for France, there came into exist- 
ence an intelligent volunteer body of nurses that 
placed the three societies in the enviable position to 
be able to furnish in the shortest possible time an 
adequate force to serve in 1,561 hospitals, with a 
supervision of 102,579 beds. They totaled over 
20,000, sufficient to cope with all cases, even at 
times when the influx of wounded almost seemed 
to be an inexhaustible stream. 

They were there, those noble women of France, 
those Red Cross nurses — ever alert, ever attentive, 
ready to do and to give of the best that was in them 
in the sacred name of patriotism and humanity. 

Lyons, for instance, had at the time of my visit 
the stupendous number of 25,000 beds, supervised 
for the most part by members of the Red Cross ; yet 
after the battle of the Marne, this number was by 
a far cry not sufficient. The very large number of 
wounded that needed aid and attention, the troop 
trains going and coming, loaded with soldiers, 
created the necessity to send the hospital trains 
over the bigger trunk lines to larger and better 
equipped military centers ; and thus it came to pass, 
that whilst such centers as Paris, Lyons or Mar- 
seilles were crowded to over-flowing other smaller 



centers situated at some branch line and far from 
the front remained empty. 

Immense Samber ef Casaalties. 

Such staggering numbers as stared us in the 
face were not dreamed of by any of the belligerents, 
hence the service was caught inadequately prepared ; 
but there was never a time when any wounded or 
suffering did not receive due attention and proper 
consideration — all received the treatment that 
France owed to her sons and defenders. The French 
Red Cross ever alert, ever on the qui vive for such 
emergencies, was there to bridge over any difficulties 
arising. 

The sphere of action, as can be readily perceived, 
was not limited therefore to the hospital service 
alone; nay, on the contrary, at every railroad sation 
where hospital trains were passing, aid stations 
were erected and soon in full swing. Here society 
ladies rubbed elbows or took tiu-ns with their sisters 
of the working classes, to look after the welfare and 
comfort of the wounded and ill ; there they prepared 
nourishing food and, where permissible, dainty 
dishes or delicacies, cigarettes, medicines, etc., etc. 
There they had also rest beds, for those who on 
account of the gravity of their cases could not con- 
tinue their voyage. 

Germany's Ready-Made War. 

But in Germany all this was different, owing to 
her organizatory talent, and above all, the fact that 
she had for forty-three years prepared herself for 
the coming struggle — everything had been made in 
readiness; everything had been foreseen; nothing 
had been left to chance; nothing was overlooked. 
Her Red Cross system was German-made, that is to 
say, patterned after the army and closely knitted 
wilii it. Hence, the Red Cross on the other side 
of the Rhine was established on a purely military 
basis, so that, not only the soldiers, but even the 
stricken civil population were looked after by them 
— in war times just the same as in times of peace. 

Thus von Behr Pinnow organized from among the 
Red Cross sisterhood, a special training corps of 
nurses, whose sole raison d' etre was to look after 
and to take care of the health of the babies in 
order to stem the frightful mortality among them 
on the one hand, and to see to it that the future 
defenders of the fatherland might grow up healthy 
in body and sane in mind, according to the Hip- 
pocratic aphorism: "HI ens sana, in corpore sano." 

French Efhciency. 

With all this, the spirit of sacrifice, as well as 
the efficiency, of the French Red Cross is equal in 
every respect to that of the German organization, 
only its division into three organizations, each inde- 
pendent of the other, instead of being welded into 
a strong homogeneous unit, is to my way of think- 
ing, rather a drawback, however small I confess. 



The American Red Cross. 

I'm rather partial to our American Red Cross 
organization. It is an organization that is unique — 
barring none. It rests on a very strong and solid 
foundation because organized along military, sani- 
tary lines. The great number of officers, nurses, 
professional and volunteer, that belong to its rank 
and file, the close affiliation it keeps up with the 
army and navy, makes it one of the most formid- 
able and efficient organizations of its kind in the 
world. It has the fullest support of the Govern- 
ment. Our President, as Commander-in-Chief of 
our Army and Navy, is ex-officio Commander of 
the Red Cross, and our highest military and naval 
officers are members of it. The whole machinery 
of the United States offensive and defensive power 
stands behind it, and above all it has the unstinted 
and loyal support of our nation, that is to say, of 
every true, red-blooded, patriotic American. 
America Called to Fight. 

And now that America has been called upon to 
fight the battles of and for the democracies of the 
world, the American Red Cross will play in this 
great world drama, as it has played Tn the past, a 
part worthy of its best and noblest traditions, which 
are the traditions of our Army and our Navy. It 
will do its duty — nobly, efficiently, abreast of the 
times — conscious that the eyes of humanity look on 
it as the embodiment of all that for which our flag 
stands, which is the visible symbolism of true Amer- 
ican ideals. 

America to the Front. 

And now as to the aftermath — after this world 
war has been fought and won with the aid of our 
forces — what shall we do with the wounded and 
maimed American soldiers? When Johnny comes 
marching home, minus an eye, arm, leg or both, 
what shall we do with him? Shall we in the first 
transport of joy at the reunion gush over him, 
idolize him for his natural life into unproductive 
idleness? I say, no; a thousand times no, and this 
with all the earnestness at my command. He has 
done his duty, faithfully, nobly, so have hundreds 
and thousands of other Johnnys done, in just the 
same unselfish, patriotic manner ; and some of them, 
aye, a great number of them, have paid the supreme 
sacrifice — slumbering now the eternal slumber of the 
hero — decked by the sod of a foreign country — so 
that their own soil may be unmolested and free 
from the tread of the enemy; so that their own 
country may live. 

The Debt of Oar Soldiers. 

But this country has contracted a debt; it is 
Johnny's debtor now, as it was Johnny's creditor be- 
fore, and that debt is not paid — cannot be paid — 
either by putting him on a back shelf as Uncle 
Sam's pensioner, or by placing him on the scrap 
heap for the rest of his life, selling pencils and 



shoestrings on some corner curbstone — a burden 
to himself as well as to those who are around him. 

It is work and service that the American soldier 
is asking of his fellow American citizens, and not 
charity ! 

Work ennobles; charity degrades. A true Ameri- 
can never degrades himself. 

Let U$ Follow the Example of France. 

France, full well recognizing the great service her 
sons had rendered to her in the hour of distress, 
and particularly recognizing at its fullest worth the 
sacrifice of the one who has suffered loss of a limb — 
France, I say, with all the finer emotions she is 
capable of forcibly repressed — gulped them down, 
and looked at the proposition that stared her in 
the face from the angle of justice and common 
sense, in a cold scientific way. She wanted to be 
just to her heroic sons, and to this end she enlisted 
the cooperation of every citizen, and particularly 
of every employer. She did not pass the hat around, 
nor did she ask financial aid of anyone, least of all 
the employer, to contribute. Nay, just the reverse. 
The Surgeon General appealed to them not to follow 
the dictates of their hearts or patriotic impulses to 
create new and unnecessary vocations, such as 
watchman, doorman, or information clerk, for the 
use and benefit of the crippled soldier. On the con- 
trary, every employer was and is asked to open his 
factory, his shop, his place of business, to crippled 
and disabled soldiers. While the Surgeon-General's 
office assured the employer, that thanks to the re- 
education and reclaiming forces of the Government, 
the soldiers will fully be able to earn every cent of 
their salaries. 

Let us do the same! 

Re-edacating the Maimed. 

Let us re-educate the maimed. Let us show him 
our true appreciation of his worth and of the service 
he has rendered to his country, by giving the 
country an opportunity to put him in a position to 
earn his own living; only so, and in no other way, 
can we pay our debt to him ; only so will he not 
lose his self-respect and ambition; so that, with 
head erect, into the shops, into the offices and into 
the professions he may go to take his place at the 
banquet table of life and to compete with his normal 
fellowmen as their equal. 

By careful training in reclaiming him, he will 
again become self-supporting, a useful and pro- 
ductive member of the community wherein he lives. 
Our Red Cross institutions are admirably fitted to 
reclaim the crippled and the blind. Coddling a 
disabled soldier is the worst thing that could happen 
to him, not barring even German bullets. Do not 
let us fall into the errors we committed after the 
war between the States. Reclaim the maimed, as 
fully 80% can be reclaimed. It is not a gift you 
are bestowing, but paying a debt, a sacred debt. 



Oar Boys Over There. 

Our boys Over There will soon be counted by the 
millions. They went with a will — if needs must be, 
to die. Thousands will come home cripple<l for 
life. Help them to conserve their grit and ag- 
gressive spirit, so truly American, they possessed 
ere they were inducted into the Service. 

Hence, let us right from the start, erect great 
reconstruction hospitals — spacious enough, fully 
equipped enough, to house and take care of thou- 
sands of these unfortunates. One such big hospital 
should be erected at least in each of the 16 military 
districts we possess; there the work should be de- 
veloped by a medico-surgical staff second to none. 
One of the first considerations in the reclaiming of 
a man is to learn his preference and aptitude for 
his new vocation or position, as a man must like 
his work; it must not be distasteful to him, else he 
will not accomplish anything. The task is a very 
hard one, I admit, to find always a suitable occupa- 
tion for one who is suffering certain disabilities, but 
it is not an impossible one, especially if we ap- 
proach our task by way of individualization. We 
must study the man, learn to individualize each en- 
tity as a new problem, because in ultimate analysis, 
each human being is a law unto himself. 

Plastic Surgery in Reconstruction. 

Above all, plastic surgery should come into its 
own, for cases needing the work of the plastic sur- 
geon are different from the case of the ordinary 
disabled soldier because they are so terribly dis- 
figured that even those who are near and dear to 
them, their own wives and children, would shrink 
from them in horror. Now by plastic surgery, 
these frightful cases can be greatly improved — new 
noses, new lips, new mouths, new ears — and by 
saking a portion from a rib even new jaws can be 
made by the dental surgeon, so that when they 
ieave the hospital they may look almost normal. 

The Blind. 

Next in importance are blind ones. This war has 
.ureHuy demonstrated that even the blind may be 
reclaimed. Some may work at their own homes, 
some in special shops for work especially adapted 
for the blind. Some may work in certain industries, 
while others even in the professions. One of the 
most eminent specialists in Chicago is a blind man. 
So, then, the blind, or those who had lost only one 
eye, the deaf, the gassed, the victims of shell-shock, 
the one-armed, the one-legged, or those who had 
lost both limbs, or who have been crippled by inter- 
current diseases, or diseases of one kind or another — 
they all constitute the vast army of creditors of 
Uncle Sam, and they must be paid — and will be 
paid— by the reclamation service. Let this be a 
special branch of the ' Surgeon-General's office — 
large enough to cope with all phases of problems 
that may confront us, because it must cover ade- 



quately, efficiently, every field that has been or will 
be influenced by the war. 

Braiia and Brawn Will Win the War. 

"But it takes money to do all this." That's true, 
but we are not a niggardly nation. We are told "Food 
Will Win the War," "Coal Will Win the War," and 
a thousand other things will win the war ; but per- 
mit me to say that it is brains and brawn that will 
win the war — and the American soldier has them 
both. He who for some reason or another is physi- 
cally disqualified to serve, has no place with the 
American Army or Navy, but he has a right, and 
that right should be given him, to serve his country 
by paying a tax of at least five dollars a year, or 
greater according to his income or earning capacity. 

In Europe, where compulsory military service by 
conscription has ruled, with the exception of Great 
Britain until late, every youth who has attained the 
age of 20-23 years, must present himself for army 
service. They serve, as in Austria for instance, 
three years in the line, seven years in the reserve. 



and 14 years in the territorial army. Those who 
are disqualified to serve must pay a military poll 
tax of 5.00 krone every year for the period of 25 
years, that is to say, from their twentieth to their 
forty-fifth year. We can and ought to pay the same 
tax. Congress has the power, and ought to enact 
some similar law. Such a tax is no more than 
right and it will yield revenue enough for the pur- 
pose outlined above. 

We Mast Win the War. 

We are now in this great war. We went into it 
with a purpose — with a grim determination to win ; 
AND WIN WE WILL! 

The American Sanitary Service plays and will 
keep on playing no mean part — it's a portion of 
the brains that helps our boys to carry Old Glory 
to Victory, because it is iJart and parcel of our 
glorious Army and Navy. And when history shall 
pass its verdict on their work — their immortal deeds 
of valor — ^may it say of them all: "Well done, ye 
servants and benefactors of humanity!" 



LIBRARY OF CONGRESS 



011 622 734 4 



Hollinge 
pH 



A 



LIBRARY OF CONGRESS 




011622 734 4 



